Poop From Biblical-Era Toilets in Jerusalem Reveals Oldest Dysentery Evidence

By examining ancient poop from Biblical-era toilets in Jerusalem, a new study has revealed that these ancient toilets contain the oldest evidence ever found of a microscopic parasite known to cause dysentery, or "traveler's diarrhoea." The stone toilets were found in elite residences, which date back to the 7 ^th and 6 ^th centuries BC.

Published in the journal Parasitology, the study showed the samples of giardia duodenalis, the protozoan that can lead to dysentery, are 2,700 years old and are the oldest ever found. 

"The fact that these parasites were present in sediment from two Iron Age Jerusalem cesspits suggests that dysentery was endemic in the Kingdom of Judah," said study lead author Dr. Piers Mitchell from Cambridge's Department of Archaeology. Dysentery is an infectious intestinal disease caused by parasites and bacteria that trigger diarrhoea, abdominal cramps, fever and dehydration. It can be fatal, particularly for young children.

Dysentery and the Toilet Habits of the Elite

The toilets were stone blocks that featured a curved surface for sitting, a central hole for defecation, and a smaller opening, possibly for urination, reports Live Science. These were positioned above a cesspit, providing a fantastic window into studying ancient poop and microorganisms for the authors of the study.

Toilets were not widespread but rather were reserved for the upper echelons of society: “While they did have toilets with cesspits across the region by the Iron Age, they were relatively rare and often only made for the elite,” the study noted. “Towns were not planned and built with a sewerage network, flushing toilets had yet to be invented and the population had no understanding of existence of microorganisms and how they can be spread.”

Dr Mitchell emphasized that it's not possible to ascertain the number of infected individuals solely from sediment samples collected from shared lavatories. He suggested the potential scenario where the latrines could have been utilized by both family members and employees. However, this remains a hypothesis as there aren't any existing records that detail such social norms.

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A stone toilet seat from the House of Ahiel, which archaeologists excavated in the Old City of Jerusalem. (Image credit: F. Vukosavović)

Previous investigations of the cesspits had unveiled eggs of whipworms, roundworms, pinworms, and tapeworms, indicating inadequate sanitation practices during the Iron Age. However, detecting the delicate cysts produced by protozoa posed a greater challenge, as these cysts are not as durable and tend to deteriorate over time.

"Dysentery is spread by faeces contaminating drinking water or food, and we suspected it could have been a big problem in early cities of the ancient Near East due to overcrowding, heat and flies, and limited water available in the summer," said Dr Mitchell.

A team comprising researchers from the University of Cambridge, Tel Aviv University, and the Israel Antiquities Authority employed a technique to identify the presence of the diarrhea-causing parasite, reports CNN.

The team obtained one sample from the cesspit at the House of Ahiel, located just outside the city walls of Jerusalem, and three samples from the cesspit at Armon ha-Natziv, situated approximately 1 mile (1.6 kilometers) south of the city. They successfully identified a distinctive antigen—a cyst wall protein produced and released by G. duodenalis—in the collected fecal samples.

Giardia protozoan. Source: Dr_Microbe / Adobe Stock.

G. Duodenalis’ Past and Present

G. duodenalis is a minuscule, pear-shaped parasite typically transmitted through contaminated food or water tainted with the faeces of an infected person or animal. The organism disrupts the protective lining of the human gut, allowing it to access the available nutrients.

Most individuals infected with G. duodenalis recover without antibiotics, but due to the breach in the gut lining, other bacteria and organisms can enter, potentially causing severe illness. Today, those affected fatally by this parasite are mostly children – those infected by a chronic version of this end up suffering from stunted growth, impaired cognitive function, and a failure to thrive.

While the exact duration of G. duodenalis' impact on humans remains uncertain, historical medical texts from Mesopotamia, one of the earliest complex societies, mention the issue of diarrhoea occurring 3,000 to 4,000 years ago.

Additionally, given that diarrhoea is prevalent in environments with overcrowding and inadequate sanitation, it is plausible that dysentery outbreaks were common in the Near East as soon as permanent settlements and the domestication of animals and plants emerged.

The scientists concluded that more research is needed “to fully understand from which regions of the world each organism originated, and when they spread to new areas due to migrations, trade and military invasions".

Top image: Ancient toilet found in Jerusalem. Source: Yoli Schwartz, Israel Antiquities Authority.

By Sahir Pandey